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Simplifying the Neurocritical Care Fellowship Process: A Solution from the NCS Trainee Committee and the Fellowship Directors Committee

By Currents Editor posted 08-06-2020 10:28


By Uttara Koul, MD, PGY4 neurology resident, St. Louis University; and Aleksandra Yakhkind, MD, PGY6 neurocritical care fellow, University of Pennsylvania

Neurocritical care attracts residents from a multitude of specialties — a majority constitutes adult neurology residents. As one myself and a Trainee Section leadership member, I shall take the onus of speaking on their behalf about our experience with the recent fellowship application process.

After surviving through a tumultuous year of internal medicine, we excitedly graduate to another intern year in neurology. The stethoscope disappears, and our pockets assimilate Tromners, tuning forks and
an ophthalmoscope that we believe we know how to use.

Add a pager, dark circles and coffee to the mix and — voila! — you have made contact with a PGY-3! The year of “establishing a footing in neurology but not quite.” Lo and behold, in less than two years, we have to decide which subspecialty we may want to pursue.

The relief of acquiring a spot in a competitive residency fades and the time to dive into fellowship applications arrives sooner than we expect. Juggling heavy rotations and simultaneously working on our applications is an ordeal in itself. With limited time to spare after work and more selective search criteria in mind, we seek a streamlined way to research programs and finalize our applications. Currently, this has proved to be a very difficult task.

This year, we, the Trainee Section leadership of the NCS, realized that the SF match and UCNS websites were helpful for our program search, but not without discrepancies.

There was a lack of comprehensive and up-to-date information and several broken website links. Program director and coordinator contact information was out of date and some programs were missing from each website. Therefore, a lot of the information we accumulated was via “word of mouth” from prior fellows and attendings. To complicate things further, each fellowship program varies in their exposure to specific neurological critical care and general critical care. Other major differences between programs include the fellow’s responsibilities in different rotations, electives offered, research tracks, etc. As of now, there are no dedicated resources available that provide the synopsis of each program in a brief yet informative manner.

Therefore, we put our heads together with the Fellowship Directors Committee to create a short survey for neurocritical care fellowship program directors and coordinators. We compiled a questionnaire that encompassed relevant data regarding each program’s unit structure, faculty numbers, fellow responsibilities, didactic schedule, elective and research opportunities, among other essential details. This was formulated with input from current applicants, fellows, advanced practice providers (APPs) and ICU pharmacists to highlight the multi-disciplinary nature of a neurocritical care training program.

We subsequently created a survey out of these questions. Once finalized, we submitted our proposal to the NCS Board of Directors and were given the green light to proceed. We are currently in the process of compiling an email list of program directors and coordinators of neurocritical care fellowship programs to distribute our survey.

Our objective is to collect noteworthy information in an efficient and organized manner from all available neurocritical care fellowship programs that participate in the match. Once completed, the survey information would be made available on the NCS website under the Trainee Section. Ideally, programs will be searchable by region, accreditation and other applicant preferences and will be viewable as a list and on a map. We are working with IT to have this website completed in time for the start of the 2020 application process. This is especially important in the era of social distancing when applicants may have to do virtual interviews in lieu of visiting a program.

We also found that comprehensive information on APP neurocritical care and general critical care training programs was lacking. We are compiling this information in parallel and also plan to share it under the APP section of the NCS website. We strongly believe that this project can better guide future applicants in planning their career trajectory. We plan to assess and track applicant experience and satisfaction before and after this intervention and are open to ideas on how to make this process better for all involved. And for PD to look out for the survey, to fill it out and for trainee members to know that it is a tool that will be coming out in the near future to help them. 


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